Organization
96TH MEDGRP-EGLIN
Active
Parent organization
96TH MEDGRP-EGLIN
Other names
EGLIN 7th SFG PHCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
96TH MEDGRP-EGLIN
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
4315 EL SALVADOR WAY, BUILDING 4315, EGLIN AFB, FL 32542-1711
(850) 885-7554
(850) 885-9977
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 885-7554
(850) 885-9977
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149365
PK
—
Enumeration date
12/19/2014
Last updated
06/11/2025
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